| Date |
Description
of
trophy uncured
trophy
received,
together
with
name of
specie-dimensions and
sex where possible. |
Date
of receipt |
From
whom obtained (Name and address
of sender or supplier) |
Nature
and kind of
licence held by sender or
supplier
|
No.
of certificate
or
ownership,
if any |
Description
of
trophy/ animal
article that is to be
prepared or manufactured. |